Reinstatement of a License Which Has Been Revoked, Surrendered or Suspended

(1) A licensee whose license has been revoked, surrendered or suspended shall petition the Board for reinstatement of the license as provided in a consent agreement or Board final decision and order. If not otherwise specified by consent agreement or Board order, the licensee shall petition the Board for license reinstatement by the following procedure: (a) Licensee shall submit a petition for reinstatement which sets forth in detail the background of the complaint and disciplinary action taken and the reasons why the license should be reinstated and shall also include: 1. Documentation acceptable to the Board of completion of the conditions of any consent agreement or final decision and order issued by the Board; 2. A detailed summary of the licensee's activities during the revocation, suspension or surrender including, but not limited to, the licensee's professional conduct, remedial actions and academic and other continuing education pursuits; 3. Documentation acceptable to the Board of completion of CEU requirements at 234 CMR 8.00: Continuing Education and any CEUs required by a consent agreement or Board order; 4. An outline of projected professional plans for the 24 month period following reinstatement; 5. If requested by the Board, statements from at least three persons attesting to the character or health of the applicant as well as the applicant's work and professional history since the date of revocation, suspension or surrender and the basis of the affiant's knowledge; 6. Upon the Board's request, a licensee shall undergo assessment by a qualified medical, psychiatric or psychological professional, acceptable to the Board, and authorize the evaluating provider to release the assessment to the Board to determine the licensee's ability to practice dentistry, dental hygiene or dental assisting in a safe and competent manner; and 7. An affidavit, signed under pains and penalties of perjury, attesting to the licensee's compliance with all laws of the Commonwealth relating to the payment of state taxes pursuant to M.G.L. c. 62C, § 49A, child support pursuant to M.G.L. c. 119A, § 16(a), to the completion of all continuing education requirements pursuant to 234 CMR 8.00: Continuing Education, and to the truthfulness of all statements contained in the licensee's petition for reinstatement. (2) If requested by the Board, the applicant, any supervisor, and treating health practitioner may be required to personally appear before the Board or a subcommittee of its members. (3) Unless the Board orders otherwise, a licensee shall not petition the Board for reinstatement sooner than two months preceding the expiration of the period of revocation, suspension or surrender. (4) No license which has been revoked, surrendered or suspended shall be reinstated prior to the licensee's compliance with the application requirements of 234 CMR 4.00 and 8.00: Continuing Education.